Provider Demographics
NPI:1629165147
Name:NATALE, PAOLA BARRIENTOS (MD)
Entity Type:Individual
Prefix:
First Name:PAOLA
Middle Name:BARRIENTOS
Last Name:NATALE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1084 VINEHAVEN DR NE
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-2438
Mailing Address - Country:US
Mailing Address - Phone:704-900-9593
Mailing Address - Fax:980-781-5531
Practice Address - Street 1:1084 VINEHAVEN DR NE
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2438
Practice Address - Country:US
Practice Address - Phone:704-900-9593
Practice Address - Fax:980-781-5531
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0093104207R00000X
FLME93104207R00000X
NC200901755207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ01757Medicaid
NC2913943Medicaid
FL272582700Medicaid
FL16119YMedicare PIN
I33405Medicare UPIN
NC2913943Medicaid
NC2075653Medicare PIN